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Objective To discuss the feasibility and curative effect of local resection on carcinoma of ampulla by duodenum.Methods 8 patients with ampulla of vater carcinoma were 1reared by local resections from January 2001 to July 2006.And one case was adenoma,the other were adenocarcinoma.Our methods of operation were the following:we cutted the vater periampullary tumor ring-shapedly far 2cm from tumor,and resected the 1.5～2.0 cmextreme of bile vessel and pancrealic duct.We rebuilded bile vessel and pancreatic duct and embedded them to duodenum.Results The 8 cases were recovered successfully,and there were on complications on them.Their average hospital days were 16 days.All of the patients were following-up,6 cases without tumor survived more than 20～68 months,and 1 case with adenoma has survived for more than 4 years.Conclusion Local resection on carcinoma of ampulla by duodenum is feasible,its wound,complications and death rate were lower.As long as the cases were suitable,parts of patients can be cured radically.
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Objective To discuss the feasibility of caudate lobe hepatocarcinoma resection and summarize the experience.Methods Seven hepatocarcinoma resection cases from October 2003 to October 2007 were retrospectively reviewed.Result All these 7 patients Were operated successfully.Three cases survived 12,18 and 23 months after carcinosectomy respectively.After operation,4 cases had been alive for 10,11,17 and 24 months respectively.Conclusions The caudate lobe hepatocarcinoma resection is more difficult and more risky,but it is still the best therapy for caudate lobe hepatocarcinoma.Reasonable operation and postoperative combined therapy can get the satisfied long-term effect.
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Objective To evaluate the effect of palliative resection of advanced primary hepatocellular carcinoma (PHCC). Methods 98 patients with advanced PHCC were divided randomly into two groups in our hospital from March 1996 to Jan. 2000:(1) Therapy group (49 cases), dealt with palliative resection of liver cancer and implanted with a drug delivery system (DDS). (2) Control group (49 cases), only implanted with DDS. Results In therapy group and control group, The decline rate of AFP was 60.0% and 31.7% respectively (P<0.05); and the survival rates of 0.5, 1, 3 years after operation were 85.7% (42/49), 60.5%(23/38), 45.4%(10/22) and 67.3%(33/49), 32.5%(13/40), 10%(2/20) (P<0.05). Conclusions Palliative resection of liver cancer can improve survival duration and life quality of patients with advanced HCC.
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Objective To understand the spectrum of bile pathogen in patients with cholelithiasis and their drug sensitivity to antibiotics.Methods Microbes automatic detection system was applied to detect the spectrum of bile pathogen and their drug sensitivities in 366 cholelithiasis patients who underwent choledochotomy. ResultAmong 366 specimen ,common cultures were positive in 258 (70 5%) in which 268 strains of aerobes were detected, and most of them were E.coli(121 strains,45 2%), Klebsiella pneumoniae (24 2%) and Enterococcus(10 1%). 14 strains of anaerobes were cultured in 32 specimen with an incidence of 44%,among which the most common type was B.fragilis (57%).Most pathogens in all the bile specimen were gram negative,73% in aerobes and 86% in anaerobes. Aerobes were highly sensitive to imipenem, tazobactam/piperacillin (TZP) and amikacin, with sensitive rate of 94%,83%, and 63%, respectively. The sensitive rate of anerobes to imipenem as well as TZP was 93% and 86% repectively. Conclusions The main pathogen in patients with cholelithiasis were Escherichia coli,Klebsiella pneumoniae, intestinal cocci and B.frailis which were most sensitive to those antibiotics such as imipenem and TZP.
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Objective To evaluate superselective transcatheter arterial chemoembolization ( TACE) plus selective portal vein embolization (SPVE) and large dose of lipiodol on advanced primary liver carcinoma (PHC).Methods Two hundred and three cases of advanced PHC were randomly divided into group treated with ordinary TACE, and that with TACE +SPVE. Results The response rate (CR+PR) was 38% in TACE group and 59% in TACE+SPVE group (P